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INTRODUCTION

Elder abuse is an act or omission resulting in harm to the health or welfare of an elderly person. Three key groups have published definitions of elder abuse.1-3 Although the incidence of elder neglect and abuse is unknown and widely felt to be underreported, the rate of different types of abuse among the elderly has been estimated to be in the mid-single digits up to 10% of persons age >65 years,4 or between 500,000 and 1 million U.S. adults.5,6 One meta-analysis identified the pooled prevalence of elder abuse overall in geographically diverse countries to be 15.7%.7 Alternatively, a clinician seeing between 20 and 40 adults over age 60 per day could encounter more than one victim of elder mistreatment on a daily basis.8 Table 295-1 summarizes the categories of elder abuse.

TABLE 295-1Categories of Elder Abuse

CLINICAL FEATURES

PHYSICAL ABUSE

Physical abuse is the most easily recognized form of elder abuse. It is defined as the use of physical force that might result in bodily injury, physical pain, or impairment. Pushing, slapping, burning, striking with objects, and improper use of restraint are all examples of physical abuse. Chemical restraint (such as intentional overmedication or administration of tranquilizers) is a more subtle form. Regardless of mechanism, physical abuse is carried out with the intention of causing suffering, pain, or other physical impairment to the abused person.

CAREGIVER NEGLECT

Elder neglect is the most common form of elder maltreatment, accounting for more than half of all elder maltreatment cases reported to adult protective services agencies annually.9 Elder neglect is defined as the failure of a caregiver to meet basic needs for a person or to provide goods and services necessary to prevent ...

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